MRI language dominance assessment in epilepsy patients at 1.0 T: region of interest analysis and comparison with intracarotid amytal testing

The primary goal of this study was to test the reliability of presurgical language lateralization in epilepsy patients with functional magnetic resonance imaging (fMRI) with a 1.0-T MR scanner using a simple word generation paradigm and conventional equipment. In addition, hemispherical fMRI languag...

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Bibliographic Details
Published in:Neuroradiology 2004-06, Vol.46 (6), p.413-420
Main Authors: DEBLAERE, K, BOON, P. A, VANDEMAELE, P, TIELEMAN, A, VONCK, K, VINGERHOETS, G, BACKES, W, DEFREYNE, L, ACHTEN, E
Format: Article
Language:English
Subjects:
Adolescent
Adult
Amobarbital
Biological and medical sciences
Brain Mapping
Carotid Artery, Internal
Child
Diagnostic tests
Dominance, Cerebral - physiology
Epilepsy
Epilepsy, Temporal Lobe - physiopathology
Female
Functional Laterality
Humans
Injections, Intra-Arterial
Investigative techniques, diagnostic techniques (general aspects)
Language
Magnetic Resonance Imaging
Male
Medical equipment
Medical imaging
Medical sciences
Middle Aged
Nervous system
Neurology
NMR
Nuclear magnetic resonance
Preoperative Care
Prospective Studies
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiology
Reproducibility of Results
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Summary:The primary goal of this study was to test the reliability of presurgical language lateralization in epilepsy patients with functional magnetic resonance imaging (fMRI) with a 1.0-T MR scanner using a simple word generation paradigm and conventional equipment. In addition, hemispherical fMRI language lateralization analysis and region of interest (ROI) analysis in the frontal and temporo-parietal regions were compared with the intracarotid amytal test (IAT). Twenty epilepsy patients under presurgical evaluation were prospectively examined by both fMRI and IAT. The fMRI experiment consisted of a word chain task (WCT) using the conventional headphone set and a sparse sequence. In 17 of the 20 patients, data were available for comparison between the two procedures. Fifteen of these 17 patients were categorized as left hemispheric dominant, and 2 patients demonstrated bilateral language representation by both fMRI and IAT. The highest reliability for lateralization was obtained using frontal ROI analysis. Hemispherical analysis was less powerful and reliable in all cases but one, while temporo-parietal ROI analysis was unreliable as a stand-alone analysis when compared with IAT. The effect of statistical threshold on language lateralization prompted for the use of t-value-dependent lateralization index plots. This study illustrates that fMRI-determined language lateralization can be performed reliably in a clinical MR setting operating at a low field strength of 1 T without expensive stimulus presentation systems.
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-004-1196-0